title: Threat and error management for anesthesiologists: a predictive risk taxonomy.
abstract: OBJECTIVE
  Patient care in the operating room is a dynamic interaction that requires cooperation among team members and reliance upon sophisticated technology. Most human factors research in medicine has been focused on analyzing errors and implementing system-wide changes to prevent them from recurring. We describe a set of techniques that has been used successfully by the aviation industry to analyze errors and adverse events and explain how these techniques can be applied to patient care.
  
  
  RESULTS
  Threat and error management (TEM) describes adverse events in terms of risks or challenges that are present in an operational environment (threats) and the actions of specific personnel that potentiate or exacerbate those threats (errors). TEM is a technique widely used in aviation, and can be adapted for the use in a medical setting to predict high-risk situations and prevent errors in the perioperative period. A threat taxonomy is a novel way of classifying and predicting the hazards that can occur in the operating room. TEM can be used to identify error-producing situations, analyze adverse events, and design training scenarios.
  
  
  CONCLUSIONS
  TEM offers a multifaceted strategy for identifying hazards, reducing errors, and training physicians. A threat taxonomy may improve analysis of critical events with subsequent development of specific interventions, and may also serve as a framework for training programs in risk mitigation.
authors.affiliation: aYale University School of Medicine, Connecticut bUniversity of North Carolina at Chapel Hill, North Carolina cUniversity of Colorado Denver, Denver, Colorado dAerospace Human Factors Research Division, Civil Aerospace Medical Institute, Federal Aviation Administration, Oklahoma, USA.
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Ruskin
authors.forename: Marjorie P
authors.initials: MP
authors.lastname: Stiegler
authors.forename: Kellie
authors.initials: K
authors.lastname: Park
authors.forename: Patrick
authors.initials: P
authors.lastname: Guffey
authors.forename: Viji
authors.initials: V
authors.lastname: Kurup
authors.forename: Thomas
authors.initials: T
authors.lastname: Chidester
mesh_terms: D000776:Anesthesiology / Q000193:education; D004501:Education, Medical; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D012306:Risk